麻醉科PDCA循环管理提高术中自体血输注率  

PDCA cycle management improves intraoperative autologous blood transfusion rate in department of anesthesiology

作　　者：张渺 李祥婷[1] 史琪清 吴品雯 方浩[1] ZHANG Miao;LI Xiangting;SHI Qiqing;WU Pinwen;FANG Hao(Department of Anesthesiology,Minhang Hospital,Fudan University,Shanghai 201199,China)

机构地区：[1]复旦大学附属闵行医院(上海市闵行区中心医院)麻醉科,上海201199 [2]同济大学附属上海市第四人民医院麻醉与围术期医学科

出　　处：《上海医学》2022年第2期90-93,共4页Shanghai Medical Journal

摘　　要：目的探讨运用麻醉科PDCA[P(计划,Plan)、D(实施,Do)、C(检查,Check)、A(处理,Action)]循环管理模式提高术中自体血输注率的效果。方法选择2018年7—9月在复旦大学附属闵行医院行手术治疗,术中输血的患者31例,作为对照组;之后9个月实施PDCA循环管理加以改进,分别收集2018年10—12月、2019年1—3月和4—6月术中输血的患者作为改进1组(28例)、改进2组(31例)和改进3组(39例)。比较各组患者的性别构成、年龄、术前和术后血红蛋白水平、术中失血量、手术种类,以及术中自体血输注率。结果4组间患者的性别构成、年龄、术前及术后血红蛋白水平,以及术中失血量、手术种类的差异均无统计学意义(P值均>0.05)。改进1组、改进2组、改进3组患者自体血输注率分别为21.4%(6/28)、41.9%(13/31)、48.7%(19/39),均显著高于对照组的19.4%(6/31,P值均<0.05);且改进2组和改进3组的自体血输注率均>35%的目标值。结论运用麻醉科PDCA循环管理模式可显著提高术中自体血输注率。Objective To explore the effect of PDCA(abbreviation of Plan,Do,Check and Action)cycle management on the intraoperative autologous blood transfusion rate in the department of anesthesiology.Methods Thirty-one patients who underwent surgical treatment and blood tranfusion in Minhang Hospital,Fudan University from July to September 2018 were enrolled into control group in this study.Then PDCA cycle management was implemented in the next 9 months.Patients who had blood transfusion between October and December 2018,between January and March 2019,and between April and June 2019 were enrolled in improvement group 1(n=28),improvement group 2(n=31),and improvement group 3(n=39),respectively.The gender,age,preoperative and postoperative hemoglobin levels,intraoperative blood loss,type of surgery,and autologous blood transfusion rate were compared among the groups.Results There were no significant differences in the gender composition,age,preoperative or postoperative hemoglobin level,intraoperative blood loss,or the type of surgery among the 4 groups(all P>0.05).The autologous blood transfusion rates were 21.4%(6/28),41.9%(13/31)and 48.7%(19/39)in the improvement group 1,improvement group 2,and improvement group 3,respectively,which were significantly higher than that in the control group(19.4%,6/31,all P<0.05).The autologous blood transfusion rates of the improvement group 2 and improvement group 3 were both greater than the target value(35%).Conclusion PDCA cycle management can significantly improve autologous blood transfusion rate in the department of anesthesiology.

关 键 词：PDCA 自体血输注 异体血输注 

分 类 号：R614[医药卫生—麻醉学]